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• Residential facilities located on the grounds of, or immediately adjacent to, any large institution or multiple purpose complex. • Correctional or holding facilities for people who are prisoners, have been arrested or detained pending disposition of charges, or are held under court order as material witnesses or juveniles. This page last updated in Release Number: 21-01 Release Date: 3/29/2021 Effective Date: 3/29/2021 45.2 Covered Services Individuals who are inmates of a public institution may be eligible for suspended BadgerCare Plus. When a member is incarcerated in a public institution, BadgerCare Plus will only cover inpatient services received while the member is outside of jail or prison for 24 hours or more. While incarcerated, members are not eligible to enroll in an HMO. Copay limits still apply to incarcerated members for any services they receive. See SECTION 45.8.5 SERVICES FOR YOUTH for information on coverage for certain pre-release and post- release services for youth. This page last updated in Release Number: 25-03 Release Date: 08/13/2025 Effective Date: 08/13/2025 45.3 Suspension Start Date The suspension period will have a start date at the beginning of a benefit month due to notice requirements, but the restriction on covered services will begin the date the person becomes incarcerated. This means that the restriction on covered services may be effective for a date prior to the suspension start date displayed in the system. See SECTION 45.2 COVERED SERVICES. 45.3.1 Applications If the applicant is already incarcerated and has been since at least the beginning of the application month, their suspension will start the first of the month of application. Example 1 Mark is incarcerated on January 17. He applies for BadgerCare Plus on April 20 and is found eligible. Mark’s suspension start date is April 1. If the applicant was incarcerated after the first of the application month, the suspension will start the first of the month following the application month. Example 2 Jane is incarcerated on April 15. She applies for BadgerCare Plus on April 20 and is found eligible. She is certified for full-benefit BadgerCare Plus from April 1 until April 30. Jane’s suspension starts on May 1. However, the restriction on covered services will be effective April 15 (the date Jane became incarcerated). 45.3.2 Backdated Eligibility If an applicant is determined eligible for a BadgerCare Plus backdate and was incarcerated during any of the backdated months, they will be enrolled in a suspended status for any backdated months in which